Heart Disease
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Coronary heart disease or coronary artery disease is a major cause of death and disability throughout the world. The basic mechanism of coronary artery disease is a build-up of cholesterol-laden plaque (a fatty deposit) inside the coronary arteries, the blood vessels that carry oxygen-rich blood to the heart. The plaque narrows the inner channel of the vessels and makes them less flexible. This process is called atherosclerosis, or hardening of the arteries.
As normal blood flow to your heart is restricted, you may experience angina (chest pain). If a clot forms or lodges inside a narrowed artery, it can completely cut off the blood flow and cause a heart attack. Coronary artery disease can very often be “silent” – producing no symptoms – until it causes a heart attack. More than 85 per cent of people who die from heart attacks are aged 65 or over. The risk of having a heart attack is higher among some ethnic groups, and many other risk factors come into play as well. A diagnosis of heart disease is usually based on your symptoms, a medical history and the presence of risk factors. Your doctor may also want you to have certain tests. • Electrocardiography (ECG) records your heart’s electrical activity and shows any abnormalities that may be present, such as disturbances in your heart rate or heart rhythm. An ECG can also help to determine if your heart is getting enough blood and oxygen. It can also show that you may have had a heart attack at some point in the past – scar tissue interrupts the electrical conduction.
• An exercise tolerance test records how well your heart functions whilst you exercise (walking on a treadmill) to help to detect any abnormal changes that occur when your heart is pumping hard.
• Coronary angiography may be used if your doctor suspects a narrowing or blockage of your coronary arteries. In angiography, a dye that shows up on an x-ray is injected into the blood stream, usually through a thin tube threaded up through an artery in the arm or groin. X-rays are taken after the dye travels to the coronary arteries. If any of the arteries are blocked or narrowed, the flow of dye-treated blood will be visibly restricted.
What is the Treatment? Many people can control the early stages of heart disease with lifestyle changes and by taking certain drugs. Sometimes surgery is necessary. Drugs Cholesterol-lowering drugs, such as statins can help, statins can lower blood levels of cholesterol dramatically reducing the risk of heart attack by one third. They work by blocking an enzyme that your body needs to manufacture cholesterol. For the symptoms of Angina, three different classes of prescription drugs can alleviate pain. They can be used alone or in combination. Beta-blockers lower your heart rate and blood pressure to decrease your heart’s workload. Nitrates (glyceryl trinitrate, GTN) open up your blood vessels, increasing blood flow to the heart. Calcium channel blockers also work to dilate blood vessels and to lower blood pressure. After a heart attack, you may receive clot- dissolving drugs or have to undergo immediate surgery.
Surgery In coronary artery bypass surgery, a healthy blood vessel – usually from your leg is removed and stitched into place to bypass the diseased artery (or arteries) in your heart. In coronary angioplasty, a catheter (a thin, flexible tube) with a tiny balloon on its tip is inserted into an artery and guided toward the blocked artery near your heart. The balloon is inflated to stretch open the blood vessel and is then removed. In some forms of angioplasty, a stent (a wire mesh device) is placed inside your artery to keep it open after surgery.
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Heart Disease
